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Benign Prostatic Hyperplasia (BPH)

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Published on : Mar 14, 2014
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Slide 2 - The Prostate Gland Male sex gland Size of a walnut Helps control urine flow Produces fluid component of semen Produces Prostate Specific Antigen (PSA)
Slide 3 - Four Areas of the Prostate Transition Zone Peripheral Zone Anterior Zone Central Zone
Slide 4 - Benign Prostatic Hyperplasia
Slide 5 - BPH Generalised disease of the prostate due to hormonal derangement which leads to enlargement of the gland to cause compression of the urethra leading to symptoms
Slide 6 - what causes BPH? BPH is part of the natural aging process (increase in androgen receptor) Dihydrotestosterone (DHT) may play a role BPH cannot be prevented BPH can be treated n n n n
Slide 7 - common symptoms decrease in the urinary stream Dribbling or leaking after urination Intermittency Hesitancy Pain or burning during urination Feeling that the bladder never completely empties n n n n n n
Slide 8 - what causes these symptoms? Prostate grows with age Pressure on the urethra restricts urine flow n n
Slide 9 - How is BPH diagnosed? Medical history Physical examination Prostate exam Urinalysis Uroflowmetry PSA blood test (level;3-10ng/ml) Transrectal ultrasound of prostate n n n n n n n
Slide 10 - when should BPH be treated? BPH needs to be treated ONLY IF: The symptoms are severe enough to bother patient and affect the quality of life Renal insufficiency Frequent urinary tract infections n n n
Slide 11 - enlarged prostate Medication Heat therapies Surgical approaches treatment options n n n
Slide 12 - medication First line of defense against bothersome urinary symptoms Manage the condition - don’t fix it Two major types: (Alpha-1-blocker) - relax the prostate and provide a larger urethral opening (prazosin,terazosin) Shrink the prostate gland (5-alpha reductase inhapitor) (finasteride) n n n n n
Slide 13 - Benefits Convenient No loss of work time Minimal risk Disadvantages Expensive Not all are covered Drug Interactions Must be taken every day Manages the problem instead of fixing it medication n n n n n n n n
Slide 14 - possible side effects of Impotence Dizziness Headaches Fatigue Loss of sexual drive medication n n n n n
Slide 15 - Destroy prostate tissue with heat Tissue is left in the body and is expelled over time (called sloughing) Transurethral Microwave Therapy (TUMT) Transurethral Needle Ablation (TUNA®) Interstitial Laser Coagulation (ILC) Water Induced Thermotherapy (WIT) heat therapies n n n n n n
Slide 16 - heat therapies Benefits Office treatments Local anesthesia Minimally invasive Reduced risk of complications as compared to invasive surgical “TURP” Disadvantages Some symptoms will persist for up to 3 months Cannot predict who will respond May require prolonged catheterization n n n n n n n
Slide 17 - possible side effects of Urinary Tract Infection Impotence Incontinence heat therapies n n n
Slide 18 - surgical treatment
Slide 19 - TURP “Gold Standard” of care for BPH Uses an electrical “knife” to surgically cut and remove excess prostate tissue Effective in relieving symptoms and restoring urine flow (transurethral resection of the prostate) n n n
Slide 20 - the “gold standard”- TURP Benefits Widely available Effective Long lasting Disadvantages Greater risk of side effects and complications 1-4 days hospital stay 1-3 days catheter 4-6 week recovery n n n n n n n
Slide 21 - possible side effects of Impotence Incontinence Bleeding Electrolyte imbalance (TUR Syndrome) May result in ICU (Intensive Care Unit) TURP n n n n n